Comparison of Nurse- versus Pharmacist-Driven Heparin Dosing Protocols and Their Impact on aPTT In-Process and Response Time

Document Type

Conference Proceeding

Publication Date

1-8-2025

Publication Title

Am J Health Syst Pharm

Abstract

Purpose: Heparin is a widely used anticoagulant in the management of various thromboembolic disorders requiring careful monitoring through activated partial thromboplastin time (aPTT) to ensure therapeutic efficacy while minimizing the risk of bleeding. Monitoring and dosing has traditionally involved nurse-driven protocols, however, recent shifts towards pharmacist-driven protocols have shown promise in enhancing dosing accuracy, reduced incidence of sub- or supra-therapeutic aPTT levels, and enhanced patient outcomes. The objective/aim of this study will be to compare the effectiveness of the pharmacist-driven protocol to nurse-driven protocols within different health system facilities. Methods: This is a health-system- wide, retrospective, observational comparison of adult patients (≥18 years) receiving heparin via dosing protocol between January 1, 2024 to June 30, 2024. Data collected include patient demographics, aPTT-related metrics (order time, collection times, result times), heparin infusion details, bolus orders, and adjustments based on aPTT. The primary endpoint is the evaluation of lab draw timeliness, focusing on the timeline from scheduled lab order to actual draw time to result, incidence of extreme high aPTT values (>200 seconds), and outcome differences between nurse-driven and pharmacist-driven units. Statistical analysis will be conducted using descriptive statistics to quantify mean, medium, interquartile range, and all other relevant metrics within the study.

Volume

82

First Page

S531

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